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SOMBA K'E/YELLOWKNIFE
The Stanton Territorial Health Authority is considering "limiting access" to patients who repeatedly miss appointments and operations.

Stanton Territorial Hospital is reporting a troubling number of no-shows for medical appointments over the 2010/2011 fiscal year, including 17.4 per cent missed appointments to see ophthalmic technicians. Here, Stanton medical clinic supervisor Dot Bergman speaks with receptionist Karen Pryznyk. - Kevin Allerston/NNSL photo

That's what Stanton CEO Kay Lewis had to say to attendees at the health authority's annual general meeting last week.

John Williston, chair of the Stanton Territorial Hospital Foundation, made the connection between missed appointments, also known as "no-shows," and longer wait times for patients.

"In your presentation, you had mentioned it two or three times, you referred to it as wait list backlogs and that you're trying to work on that," Williston said to Lewis.

"You also mentioned a concern about no-shows, and in my mind there is likely a correlation there that impacts the wait lists. There's work being done on that, but what are the possibilities there?"

Lewis emphasized the need for educating the public about the importance of not missing appointments, but added the hospital will have to take a stand at some point.

"At the end of the day I think it may become a little bit harder ... and if you don't show, at some point in time, your access is going to be limited," said Lewis.

"It's very important that you make the rule clear. It's absolutely something that we need to address. We need to educate people about the impact, but we have to make ethical decisions about what we want to do."

According to Stanton's 2010/2011 annual report, the no-show rate for specialty services ranged from a low of 2.86 per cent for oncology to a high of 17.4 per cent for appointments to see a ophthalmic technician. The statistics show that for a one-year period up to the end of March of this year, 4,537 appointments were missed at Stanton Territorial Hospital. Of that total, 321 were for surgeries.

Lewis didn't offer any specifics when Yellowknifer later asked what sort of sanctions the health authority might be considering in their efforts to curb no-shows.

"I think the first part is creating the public awareness that this is an issue that affects the costs and wait lists for certain programs," said Lewis.

"I think, as well, we need to ensure that our system is appropriately accommodating people and educating them in that process," she said, adding Stanton is examining the reasons for no-shows and that hospital officials "can't always blame the victim" when an appointment is missed.

Lewis said that a missed appointment, even for an operation, is not always the patient's fault, pointing to delays in medical travel as an example.

"It's something that always surprises me ... We have different circumstances, people flying in, some of it can be related to travel and many things like that, but at the end of the day it certainly does concern me that we have that level of no-show," said Lewis.

"You know the part for me is that a no-show means someone else has missed that opportunity as well. And that's where you start to get quite concerned."

While she couldn't put a dollar figure on the effects of missed appointments and operations, she did say it has a big impact.

"At a surgical cancellation, there's a lot of very expensive resources, it's one of the most expensive resources that we have in the business," said Lewis.

Dr. Hassan Adam, owner of Adam Dental Clinic, said while no-shows used to be an issue for his clinic in its earlier days, it is a rare occurrence now due to the clinic's policy of calling patients to remind them the day before their appointments.

"I think in terms of the volume of people we see, it's very rare," said Adam.

He said the clinic serves nearly 200 patients a day, and if there were 10 no-shows in a day that would be above average.

He said his clinic began the 24-hour notice policy in early 1980s. If patients still missed appointments after the call, they are re-scheduled for the last appointment of the day. He said this continues until they prove they will show up.

"We used to get almost 50 per cent no-shows in the early 80s," said Adam.

Yellowknife resident Richard Lau said while he thinks it is important for people to make their appointments, it isn't fair for the health authority to limit access.

"If they have an appointment, they should show up, of course," said Lau. "Of course that's not fair," he said, noting that it's a service we all pay for.

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